Towards an international framework for communication disorders: Use of the ICF
Department of Communication Sciences and Disorders, Saint Louis University, 3750 Lindell Blvd., St. Louis, MO 63108, USA.Journal of Communication Disorders (Impact Factor: 1.45). 07/2006; 39(4):251-65. DOI: 10.1016/j.jcomdis.2006.02.002
There has been an interest in the World Health Organization's framework of functioning and disability by those in communication disorders since the original 1980 International Classification of Impairments, Disabilities, and Handicaps (ICIDH). In 2001, WHO published the substantially revised International Classification of Functioning, Disability, and Health (ICF). This framework is gaining in acceptance as a system that would be beneficial for the field and for our clients. This article describes the basics of the ICF and how it differs from the ICIDH; the possible applications of the ICF to communication disorders; some of the work done with the ICF in communication disorders internationally; and the benefits to the field from increased interdisciplinary and international collaboration using the ICF as a common framework. LEARNING OUTCOMES: As a result of this activity the reader will be able to: (1) describe the basics of the ICF, (2) describe the applications of the ICF to communication disorders, and (3) describe the possible impact upon the field internationally.
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- "In ICF, the elements inherent in AT assessment and selection including body structure and function, activity and participation, and environmental and personal factors. The ICF provides a common reference framework for better communication between the clinicians, patients, and their families , . However, the classifications set up by the ICF cannot lead to better patient care without an improved problem-solving technique . "
ABSTRACT: Many disabled individuals lack extensive knowledge about assistive technology, which could help them use computers. In 1997, Denis Anson developed a decision tree of 49 evaluative questions designed to evaluate the functional capabilities of the disabled user and choose an appropriate combination of assistive devices, from a selection of 26, that enable the individual to use a computer. In general, occupational therapists guide the disabled users through this process. They often have to go over repetitive questions in order to find an appropriate device. A disabled user may require an alphanumeric entry device, a pointing device, an output device, a performance enhancement device, or some combination of these. Therefore, the current research eliminates redundant questions and divides Anson's decision tree into multiple independent subtrees to meet the actual demand of computer users with disabilities. The modified decision tree was tested by six disabled users to prove it can determine a complete set of assistive devices with a smaller number of evaluative questions. The means to insert new categories of computer-related assistive devices was included to ensure the decision tree can be expanded and updated. The current decision tree can help the disabled users and assistive technology practitioners to find appropriate computer-related assistive devices that meet with clients' individual needs in an efficient manner.
- "Despite the presentation of this information, data on the prevalence and incidence feeding problems in the pediatric population are limited. Possible reasons for this paucity are that disabling or disease conditions are more likely to be counted than are symptoms of diseases (eg, dysphagia)   , terminology for the coding of feeding-related behaviors may be reflected by multiple underlying diagnostic conditions , standardized diagnostic protocols are lacking, and differences exist in methods of ascertainment  . Additionally, it may be challenging to distinguish between feeding patterns associated with variability during normal development and those associated with impairment. "
Article: Pediatric Dysphagia[Show abstract] [Hide abstract]
ABSTRACT: Feeding and swallowing disorders during childhood are on the increase and typically occur in conjunction with multiple and complex medical, health, and developmental conditions. A multidisciplinary approach is essential for the evaluation of these disorders and the prompt initiation of appropriate treatment. Following a brief description of the terms feeding and swallowing, this article provides an overview of the available epidemiologic data on dysphagia and its common diagnostic conditions, impact, evaluation, and management in the pediatric population.
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- "With this approach, the first consideration in a clinical feeding evaluation is the child's level of participation in mealtime environments. Other dimensions to consider include functioning and disability (body functions, body structures, and activities and participation), contextual factors (environmental—external to an individual's control), and personal factors (unique to each person, such as past experience or background) [WHO, 2001; Threats, 2006]. Details on the ICF can be found at http://www.who.int/classifications/icf/en/ . "
ABSTRACT: Assessment of infants and children with dysphagia (swallowing problems) and feeding disorders involves significantly more considerations than a clinical observation of a feeding. In addition to the status of feeding in the child, considerations include health status, broad environment, parent-child interactions, and parental concerns. Interdisciplinary team approaches allow for coordinated global assessment and management decisions. Underlying etiologies or diagnoses must be delineated to every extent possible because treatment will vary according to history and current status in light of all factors that are often interrelated in complex ways. A holistic approach to evaluation is stressed with a primary goal for every child to receive adequate nutrition and hydration without health complications and with no stress to child or to caregiver. Instrumental swallow examinations that aid in defining physiological swallowing status are needed for some children. Successful oral feeding must be measured in quality of meal time experiences with best possible oral sensorimotor skills and safe swallowing while not jeopardizing a child's functional health status or the parent-child relationship.
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